Undignified Maternity Care During Childbirth: An Ethnographic Study on Midwives' Perspectives in a Community Healthcare Centre in South Africa

Undignified care of women during labor has been associated with increased preventable maternal morbidity and mortality. The purpose of this study was to explore midwives' perspectives on undignified care of women in a midwife's obstetric unit within a rural community healthcare center in South Africa. Using ethnographic methods, seven midwives were recruited to participate in individual interviews and participant observations were conducted in the unit. Three main themes describing undignified care were identified based on an inductive analysis of observations and interview data. These included a lack of respect for women's bodily autonomy during labor, structural challenges in the provision of quality maternity care, and the lack of confidential care for women in labor and delivery. The study findings show that obstetric violence remains a serious crisis in the well-being of women during childbirth. Policy development by stakeholders in maternity care, including operational healthcare practitioners, should prioritize training, monitoring, and peer support on dignified care and curbing disrespect and abuse of women during childbirth, which seemed to be deeply rooted in the routine unorthodox treatment of childbirth.